Ave Maria clinic owner submits application to build 25-bed hospital

Braden Clinic in Ave Maria has widespread support for a proposed 25-bed hospital, yet state regulators also consider need and viability in deciding to approve or deny a new hospital.

Dr. Beau Braden, who operates Braden Clinic at 5068 Annunciation Circle, submitted a detailed application of more than 2,000 pages to state regulators seeking a certificate-of-need license to build a 25-bed hospital.

The proposed site is on Arthrex Commerce Drive near Oil Well Road. It would be a private for-profit hospital that would offer an “efficient pared down menu of services” that would meet the needs of the fast-growing area that includes Ave Maria and Immokalee.

“Lack of medical access is adversely impacting patient outcomes,” according to the application. “Inpatient data from patients from the primary serve area indicate severe problems with the health status of residents.”

The pared-down model, which sometimes is referred to as a micro hospital, would "form a bridge between people with little access to quality care and the medical centers that can best meet their needs," the application states.

"Our hospital will not be a direct competitor with existing medical centers in the area, but a mutually beneficial collaborator."

Residents of Ave Maria and Immokalee drive 40 to 70 minutes to get to the nearest hospitals, which are 30 miles away. If the new hospital is approved, residents would be nine to 17 minutes from Braden Clinic Hospital.

Braden’s application states 85 percent of the proposed hospital’s patients would come from Ave Maria and Immokalee and the surrounding rural communities. The remaining 15 percent of patients would come from Ochopee, Orangetree, from the Seminole Indian Tribe and elsewhere.

The hospital also would serve residents of future Rural Lands West development, which could add 10,000 homes in the region.

The state will issue its decision June 1, but objections from competitors and decision appeals could extend the outcome for a year or longer.

A more contentious market battle is underway in Lee County, where HCA Healthcare has submitted an application to build an 80-bed hospital in Estero. The HCA project is going up against Lee Health’s bid to build an 82-bed hospital at its medical complex at Coconut Point in Estero.

Officials at the NCH Healthcare System and at Physicians Regional Healthcare System, both in Collier County, have 21 days from the April 11 application submissions to decide whether they will object to any or all of them.

“NCH is closely monitoring the (certificate-of-need) application process and will be urging (the state) to deny all three applications," NCH spokeswoman Debbie Curry said in a statement. "NCH remains fully committed to serving all of our patients with the highest level of quality care in the community."

Physicians Regional Healthcare System, through a spokesperson, said, "We are currently reviewing all three (certificate-of-need) applications, and weighing our options."

As required in certificate-of-need applications, Braden offered hundreds of pages of demographic data outlining explosive growth in Ave Maria and the surrounding areas, along with data about the need for a hospital in the region.

"The number of heart attacks in the service area is increasing more quickly than the population," according to the application.

In addition, the region has had a 12 percent increase in the infant death rate over the last three years, compared with a 31 percent decrease in the infant death rate elsewhere in Collier.

Three percent of stroke patients who live in the area receive the lifesaving intervention to reverse a stroke that is the standard of care.

Braden projected that in 2021, the first full year of operation if approved, the hospital would have an inpatient utilization rate of 56 percent, with steady growth to 74 percent by 2025.

About 68 percent of the expected patients are on Medicaid, uninsured or self-pay. An additional 21 percent are on Medicare, and 11 percent are insured commercially.

Braden Clinic's financial data show it ended 2017 with a net loss of $86,000, based on net patient revenue of $525,000 and operating expenses of $611,000. The proposed hospital would have 68,000 square feet and cost $34.5 million to build.

The hospital would be built by private investors who have committed funding toward the capital expenditure and corporate sponsors willing to provide a grant to cover the operating costs until the hospital breaks even, according to the application.

Braden submitted 650 letters of support from residents, community leaders and business owners. Gathering letters of support is a common practice for hospital applicants.

Letters were submitted by Blake Gable, chief executive officer of Barron Collier Companies, and Patrick Utter, vice president of Collier Enterprises, two companies that are among the largest land developers in eastern Collier.

Barron Collier Cos. is the developer of Ave Maria; and Collier Enterprises is in permitting stages for a community 5 miles west of Ave Maria. That proposed new community could bring up to 10,000 new homes, nearly 2 million square feet of commercial space and 6,000 jobs.

“Collier Enterprises feels strongly the residents, workers and visitors to Eastern Collier would benefit from an area hospital and reduced travel time to receive proper care,” Utter says in the letter.

Collier County Commissioner Bill McDaniel, whose district encompasses eastern Collier, said it’s time for a hospital in that region. McDaniel said the average ambulance time to the nearest hospital is typically one hour with no traffic delays.

McDaniel said his district is medically different from the rest of Collier and the U.S. He contended residents of Syria, Afghanistan and Bangladesh have better access to hospital beds per 1,000 people than the residents of Immokalee, Ave Maria and Golden Gate Estates.

“We have 0 hospital beds per 1,000 residents within a 30-minute drive of Ave Maria and Immokalee — a metric that is used by the World Health Organization to designate developing countries,” he wrote.

Additional letters of support were submitted by Avow Hospice, the Collier County Housing Authority, Ave Maria University, the Redlands Christian Migrant Association, the Immokalee Community Redevelopment Agency, the Healthcare Network of Southwest Florida and others.